Why trust the government about bird flu?

Revere: Whether we should trust the government to tell us the truth when a major disaster occurs, maybe only time will tell. But there are some facts for us to think about: 1. Bird flu has shown its ability to mutate and kill humans (the sequence of the 1959 H5N1 Scotland avian isolate is very different than the 1997 Hong Kong human isolates), 2. H5N1 virus is not at all stable as seen in different human isolates (e.g. the Vietnam 1203 strain is more virulent than VN 1204 strain), 3. Environmental factor and its effect on bird flu's ability to mutate are both unpredictable (bird flu outbreaks have been reported in Indonesia since 2003 but human cases and deaths did not show up until the summer of 2005, a few months after the devastating 2004 Indian Ocean earthquake and Tsunami). In time of a nationwide disaster like a pandemic influenza, citizens and government agencies should work together and help each other to distribute the relevant information (because the government can't be everywhere to collect information) to those who need the information to stay away from the hot zones or help others who can't help themselves without jeopardizing their own lives. Otherwise, chaos will destroy us faster than a pandemic influenza will. Would you agree?

flulearner: I don't see that environmental factors affect mutation rates, or if they do I don't know what the mechanism would be. Nor do I know that H5N1 mutates any faster than any other negative sense RNA virus. They all mutate a lot but most mutations are bad for the virus. I believe strongly in sharing but I don't think restricting travel makes any sense. No one I know thinks that will make a bit of difference and thereis no evidence it is feasbile or effective. I am a strong proponent of information sharing.

Well, the guy (whoever he is) may be right, but his comments are not very helpful IMHO.

Do they undo the damage that's been done? No.
Does he offer any alternative, like who should the public believe? No.
If politicians have low credibility now, is he offering any suggestions for them to improve that? Like try telling the truth? No.

ALL he is doing, IMHO, is giving politicians MORE reasons for not telling the public to prepare, with the perverse logic that no one will believe them anyway.

Does that help anyone?

Susan: Hard to tell if you are right or not. But he is right. And usually I think there is value to saying the truth unless it is obviously harmful. In this case I think the authorities need to be reminded that these things have consequences that goes beyond foreign policy or whatever else they are caught lying about. So I don't think it is unhelpful. How helpful it is we'll never know. It's always a confluence of many things that produces the final result and in this case we don'tknow in which direction it pushes things. I tend to think it's better to say it than not.

Revere, you wrote: "usually I think there is value to saying the truth unless it is obviously harmful."

Can you think of any public health examples of when it might be "obviously harmful" to tell the truth?

PF: Yes. If you reveal private information about someone, for starters. If the information is hurtful and not particularly helpful. I'm sure I could think of others. Some things will be a matter of judgment, which is unavoidable. But I think the general principle is clear enough and too infrequently honored.

revere,

I don't disagree. It's just that I would rather politicians come out and talk about bird flu and are disbelieved, rather than not having them talk about it, which is the current situation in the UK.

In other words, his comments set us even further back, from the day when we might see some politician being willing to talk about bird flu, you know.

Susan: I think my point was different. If no one trusts them, then we run the risks that what they say about bird flu will be disregarded or thought to be just another lie. My point was that trust has to be earned and earning it is not confined to the public health sector. If they lie about other things it affects what people believe when they talk about public health.

Oh, the case for going to Iraq was obscured. We didnt find any WMD's, but the Syrians were happily fitting VX , Tabun and Sarin up onto 600 missiles and in quantities far exceeding what was known for them to have. They were aiming them at Israel. But why should we believe that they didnt make it themselves?

It might be that the casings had Iraqi markings on them? But why should we believe that they werent Syrian? I dont know. I am sure the Iraqi's would rather have Saddam back. Maybe you are right.

But why should we believe government about BF? Because its government and very likely since Roosevelt we have been lied to time and again. I was a young man when Nixon stood before the people and said, "I am not a crook" and before the next years end, he was gone. Johnson sent a resolution to Congress and told us about the Gulf of Tonkin incident where on the first pass the N. Vietnamese were supposed to have fired on our destoyers in international waters. The incident apparently never happened. On the second incident and the next day, we opened fire first. Thus the door was opened for Vietnam.

William Jefferson Clinton sat and said, "I dont know Ms. Lewinsky, I never had sexual relations with that woman." Then he lied to a federal grand jury and to a federal judge under oath about the affair. He was impeached, but not carried forward thru the House. We were lied to in the same time frame about Kosovo that had been simmering for ten years and genocide was fully underway there. It only became an issue when the presidential penis was exposed.

Then there was Katrina. The Democrat governor of Louisiana Blanco sat and watched her people go under water while she haggled over the law with then President Bush about control of federal troops. The questions from reporters grew more harsh by the hour as the body counts grew. It was in hindsight by many a Bush Bash to say that Katrina was his fault. The law being specific, the tie breaker was made by Mayor Nagin who said he was going to go out onto the tarmac and out them both. Later it was found that the President acted fully within the law, but the Democrats were able to put the Katrina response onto then director of FEMA Brown and the President indirectly. The media never asked why the federal troops were not sent in immediately. A lie by government or an omission?

Lately, Jimmy Carter lied in his book about a massive bombing of Lebanon by Israel. In fact fire was witheld because Hezbollah commandeered and hid in and around schools. Estimated total of by pounds dropped by Israel was less than 75,000. Most were GBU's and laser munitions which kept the collateral damage to a minimum.

And the latest is that former Prez Clinton said that former Prez Bush would be sent on a mission by the newly elected President Hillary Clinton to tell the world that the US is open for business and to repair our image in the world. .

Nyah, the government would never lie to us.

Now we have BF to deal with. But we also have XDR-TB and a plethora of other things and they seem to be getting the upper hand. Its all about control of the masses and to ensure that things dont get out of control until they are absolutely uncontrollable. Theoretically, the idea is to keep everyone calm and let government take care of the problems.

Put yourself into this position. You have just found out that BF is fully human to human and 1000 people in say the UK have been infected. Its uncontained and the 1000 just bumped up by another 250 in three hours, the viral blanket has been thrown, the hospitals are taking 100 cases per hour and 15 people on a flight from London to the US have been found ill in the terminal at JFK. People that were on the same plane that were transiting on to other places such as Atlanta, Boston, Chicago, Dallas, Los Angeles, Memphis and Minneapolis are all on other planes and the pilots are reporting that people are sick and getting sicker. What would you do if you were the government? The trip wire has been severed. Do you tell the people the truth or do you minimize it? Do you lie if you can to allow for the PTB to get into place, or do you say that a lot of people are about to die?

If you tell the truth you cause a panic. If you lie you get Bushwhacked after its all over.

What would you do?

"I am afraid that my explanation may disillusion you, but it has always been my habit to hide none of my methods, either from my friend Watson of from anyone who might take an intelligent interest in them."-Sherlock Holmes

Susan, it means that planning for epidemics need to take this into account. It means exploring other options for dissemination - line up trustworthy celebrities beforehand for a concerted message would be one possibility (if people in power aren't trusted, find people who are). Or prepare to have local, trusted people - firemen, physicians - augment warnings, assuring people that it is for real and suggest what to do on a specific, local level.

Pointing this problem out is actually very helpful.

H5N1 avian flu: Spread by drinking water

There is a widespread link between avian flu and water, e.g. in Egypt to the Nile delta or Indonesia to residential districts of less prosperous humans with backyard flocks and without central water supply as in Vietnam: http://www.cdc.gov/ncidod/EID/vol12no12/06-0829.htm. See also the WHO webside: http://www.who.int/water_sanitation_health/emerging/h5n1background.pdf and http://www.umwelt-medizin-gesellschaft.de/ abstract in English ?Influenza: Initial introduction of influenza viruses to the population via abiotic water supply versus biotic human viral respirated droplet shedding? and http://www.thelancet.com/journals/laninf/article/PIIS1473309907700294/a… ?Transmission of influenza A in human beings?.
Avian flu infections may increase in consequence to increase of virus circulation. Transmission of avian flu by direct contact to infected poultry is an unproved assumption from the WHO. Infected poultry can everywhere contaminate the drinking water. All humans have contact to drinking water. Special in cases of small water supplies this pathway can explain small clusters in households. In hot climates and the tropics flood-related influenza is typical after extreme weather and natural after floods. The virulence of the influenza virus depends on temperature and time. If young and fresh H5N1 contaminated water from low local wells, cisterns, tanks, rain barrels or rice fields is used for water supply the water temperature for infection may be higher (at 24?C the virulence of influenza viruses amount to 2 days) as in temperate climates (for ?older? water from central water supplies cold water is decisive to virulence of viruses: at 7?C the virulence of influenza viruses amount to 14 days).
Human to human and contact transmission of influenza occur - but are overvalued immense. In the course of influenza epidemics in Germany, recognized clusters are rare, accounting for just 9 percent of cases e.g. in the 2005 season. In temperate climates the lethal H5N1 virus will be transferred to humans via cold drinking water, as with the birds in February and March 2006, strong seasonal at the time when drinking water has its temperature minimum.
The performance to eliminate viruses from the drinking water processing plants regularly does not meet the requirements of the WHO and the USA/USEPA. Conventional disinfection procedures are poor, because microorganisms in the water are not in suspension, but embedded in particles. Even ground water used for drinking water is not free from viruses.
In temperate climates strong seasonal waterborne infections like the norovirus, rotavirus, salmonella, campylobacter and - differing from the usual dogma - influenza are mainly triggered by drinking water, dependent on the water's temperature (in Germany it is at a minimum in February and March and at a maximum in August). There is no evidence that influenza primarily is transmitted by saliva droplets. In temperate climates the strong interdependence between influenza infections and environmental temperatures can't be explained by the primary biotic transmission by saliva droplets from human to human at temperatures of 37.5?C. There must be an abiotic vehicle like cold drinking water. There is no other appropriate abiotic vehicle. In Germany about 98 percent of inhabitants have a central public water supply with older and better protected water. Therefore, in Germany cold water is decisive to the virulence of viruses.

Dipl.-Ing. Wilfried Soddemann - Free Science Journalist - soddemann-aachen@t-online.de - http://www.dugi-ev.de/information.html - Epidemiological Analysis: http://www.dugi-ev.de/TW_INFEKTIONEN_H5N1_20071019.pdf

Howdy Randy, Watson calling... Nah! Not "London Calling" by the Clash, but it's pretty much the same thang. I agree with you as usual (apart from some of your political analysis)...

I wrote a posting re: your comments on Stephen King but Revere seemingly has censored what I wrote -- boo moan & bloody hiss, he/she/they appear to be a wee bit "precious" on that whole GM causation thang for bird flu, etc!

Jon: I rarely censor things. I have been sick and probably it got past me when it got caught in the spam filter. I'll go look to see if that's where it got hung up.

Revere, I hope you're feeling better. Sorry if I got a bit heated in incorrectly assuming you censored my comments. It's all good:*) Thanks dude!

> I don't think restricting travel makes any sense.
> No one I know thinks that will make a bit of
> difference and thereis no evidence it is
> feasbile or effective

http://www.advisorybodies.doh.gov.uk/sagpf/minutes/sag-modelling-summar…

Having taken 2 to 4 weeks to build up in the country
of origin pandemic flu could take as little as 2 to 4 weeks
to spread from Asia to the UK, with the peak of the UK epidemic
following about 50 days later.

Imposing a 90% restriction on all air travel to the UK would
delay the peak of a pandemic wave by only 1 to 2 weeks. On the
other hand a 99.9% travel restriction might delay a
pandemic wave by 2 months.

If restrictions on travel from all countries which had epidemics
of pandemic flu were put in place internationally the effect could
be somewhat greater: a 90% reduction might delay the spread by
3 to 4 weeks and a 99.9% effective ban by 3 to 4 months.

The above delays may be important if there is a substantial
seasonal effect on the transmissibility of flu. If there is,
it may be possible to buy enough time to shift what would
otherwise have been a winter outbreak to the spring (or a
spring outbreak to the summer), when the lower transmissibility
would result in a smaller outbreak. Although this seasonal effect
is potentially significant, strong evidence for such an effect has not
yet been presented.

"The public wonders why, if the government lied to us about Iraq for their own personal or political gain, why wouldn't they lie to us about the threat of pandemic flu? And the answer is . . . ?"

I always ask "Who benefits?" There is money to be made in disaster capitalism and power to be gained from reengineering societies after a disaster.

Besides, they are not lying if they don't say anything. Support the infrastructure of public health? To admit a problem would be to commit to aforementioned support, wouldn't it? Better not to say anything. And when the other shoe drops, well, we can use that as an excuse for implementing things we haven't been able to.

MRK said above:

"If you tell the truth you cause a panic. If you lie you get Bushwhacked after its all over."

First, it is the rare exception and not the rule that the public will panic when given the truth when the truth is known.

Second, to the degree any panic will result, wouldn't it be better to deal with it now than in the twilight between pandemic announcement and pandemic arrival.

The persistent myth of public panic is a corrosive 'misunderestimate' of the public.

It is much more likely that the government will fall into panic (or maybe already has) and will resort to lies to try to gloss over its own inadequacies.

I started a discussion some time ago about this and while I see some encouraging signs that government has decided to enlist the public as an part of the solution instead of looking at them as mostly a problem, the myth of panic persists.

It is no excuse for lies or hiding the truth.

A government that does not trust its people will breed a people that do not trust its government.

http://www.newfluwiki2.com/showDiary.do?diaryId=420

IT-Woods. If it were me I would have told them the truth from the beginning and they really indirectly have about pandemic. It was contained in the NPFP and I can count 10 people that I know that read it. So whats the response? it is that they will not be riding to the aid of the states. They took a look at it, the costs of 50 plus Katrina's in every state and there aint that much money on the planet much less in the US till to cover it. They dropped back to the Constitution. States rights means states problem...Especially after the Congress says so.

So they farmed a bit of money out but its no where near enough to cover the problems and that is definitely with an "s" at the end. But as we have now seen what might happen with the high CFR's if it comes 83% cut to half still means 1/2 of the planet and its just staggering. I praise Revere for getting the word and and to all of the sites that keep adding people to their stream every day. Some will try to make money off of it. I will just by default of my type of business, many will lose their businesses. Ther wont be anything but pieces of our society left after a pandemic of that proportions. We pick up the pieces and move on.

But to coin a phrase, "The truth is out there" but not many in the US are looking for it. Why should they? The news tells them everything they need to know. Its definitely on the EU radar and likely wont be here until something major happens over there. Revere derides Fox for their reporting and I disagree a lot. Every now and then they pump one up that really pisses me off. The latest was from Gutfield that seized upon the OIE statement by Valat that caused more problems and questions than it solved and they reported "BF is no longer a problem. Overblown, dont worry." rather than the same day statement that the WHO finally, and I mean finally acknowledged that BF was now at high level pan 3 or low level pan 4.... limited human to human transmission. They still havent called pan 4 because its apparently contained. But WTF why they wouldnt have reported both on the pundit program I have no idea. They get the AP, UPI, AFP news feeds and only an idiot without an out later would make this particular statement. They HAVE and HAD to have known it was H2H.

My response was swift and I dropped about two months worth of news, the CIDRAP, Pro-Med, EM and several others on them. I got an email back at 13:00 that said they had read it all and that they were going to likely revisit this. Okay but when? I dont want them to say its not coming, I want them to say you should be prepared for all eventualities.
I dont look at it as doom and gloom. I look at it as being prepared. Anything you do will help increase the outcomes if it does, and you simply dont have to worry about them if it doesnt. You get to go to kids birthday parties, watch the Patriots kick someones ass, have a secular Xmas in an atheistic house because we are able to do it.

anon's post is almost dead on with DHS projections. One of which is that by the time they acknowledge that its here if it does come, it will be far, far too late. With only what could be described as abject terror on the parts of parents and the poor when the media starts to hype something we could see a huge turnout of people that will simply spread it, or not.

ITW-He could be right. People might not panic. But in my long history of the military and being in situations where all you have to do is get them into the streets and saying one thing which I think the media will provide, the outcome could only be bad. I will meet him/her halfway on this one because panic will break out somewhere for sure if it comes in high path. Its derogatory to the public for sure, but what have they shown us lately. If we were seeing a story a day or more as they are in the UK, then we might be getting a better response. But we arent. .

"You cant handle the truth"...Jack Nicholson-A Few Good Men

Even were I so foolish as to trust the government, I would never believe that what it was telling me was really 'for my own good'. It hardly matters at this point if the government is able to discern and provide the truth. What is its goal in doing so and what does it intend to do about it?

I just read an article about increasing wait times in US ERs. People can't rely on timely care for real conditions that are killing them or ruining their health right now. I can't see that spending time and money keeping people apprised and afraid of as yet nonexistent threats without creating a real structure for public health care constitutes trustworthy, good government.

Revere, you wrote: "usually I think there is value to saying the truth unless it is obviously harmful."

Can you think of any public health examples of when it might be "obviously harmful" to tell the truth?

Posted by: Path Forward | January 13, 2008 9:05 PM

I think there can be times when government is caught between telling the truth and fulfilling their obligation to protect us. I am not coming up with a dramtic example right now, but if there was an immenant pending disaster and they knew there would be more deaths from the panic of telling us they might choose not to tell us.
Dave Briggs :~)

revere and Janne,

No one disagrees that telling the truth is good and important. And no one disagrees that distrusted politicians are bad spokespeople if you want to disseminate information about BF. But the point is, the only people who have their eyes on this issue are those who already know and therefore don't need to be told, and those who are supposed to do the telling but are not trusted. No one else cares.

If you believe that liars will suddenly change their behaviors just cos of some such exhortation from such a professor or members of the public, fine. Since I don't, and since I believe that those same liars are very keen on keeping the truth from the public, the only thing IMHO such a statement will achieve is to give more excuses to these liars to NOT talk about the subject at all.

The rest of the public who don't know and don't care will read this article and either ignore it or become even more convinced that BF is to be lumped with all the lies that politicians have ever told.

I ask again, is that helpful?

And Janne, when you say 'explore other options for dissemination', there is a difference between suggesting it here like putting it on a wishlist, and being able to make it happen. If you can make it happen, thanks and I wish you well. Otherwise, this guy's comment is still unhelpful.

Susan: I guess you are more cynical than I am. Your logic suggests it doesn't matter what anyone says. I disagree. The logic of the post is that public health people need to care more about what politicians say about things that seem unrelated and they themselves need to speak the truth about those things, even when they seem unrelated. Many people here seem to think that the Bush administration lies about Iraq have nothing to do with bird flu and that if their interest is in bird flu we should keep the conversation on that. The post expresses a different position. Your mileage may differ.

revere,

Well, yes I'm very cynical on this issue. And yes, our mileage differ. ;-)

Oh BTW I'll believe public health people are willing to speak the truth about BF PUBLICLY AND IN SUBSTANTIAL NUMBERS if and when that happens.

Susan: The "truth" isn't so simple. Public health is under such pressure that "the truth" for many is that the people dying today take precedence over the ones that might die in a month or a year. Maybe you think that is short sighted and history will prove it one way or another. But I am not so hard on those in the front lines who choose to talk about other things than you or I (e.g., TB, HIV/AIDS, malaria, PTSD, the problems of the homeless, etc., etc.). They are also speaking "the truth" and from their point of view we are dishonestly silent.

revere, No, I'm not being hard on public health professionals. They have many things on their plate, and they have priorities just like everyone else.

I'm just making the point that when I look around, I can't find very many people keen on telling the public about preparing for a pandemic, for whatever reason. And I don't mean telling about worst case scenarios or TEOTWAWKI. I am talking about even just telling people about official recommendations.

The issue under discussion was whether this professor's comments would or would not help if you really wanted the public to be informed about BF. And my POV is that these comments will give politicians even more reasons to not talk about it, while at the same time there isn't much public education coming from professionals either.